Title: Splenic Flexure Diffuse Large B Cell Lymphoma With Bowel Obstruction: A Radio Pathological Correlation
Authors: Abhishek Dwivedi, P K Dhagat, Kasi Viswanathan M, S N Singh, Shalini Singh
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.09
Background: The colorectal lymphoma encountered rarely among the colonic malignancies. Early diagnosis is often challenging because of non specific symptoms, with subsequent delays in diagnosis and management. We describe a rare case of large B cell lymphoma of splenic flexure with associated obstruction. Case Presentation: A 73-year-old male with a 6 days history of vague abdominal pain, constipation and melena was referred to our hospital. Computed tomography scan of abdomen revealed the presence of a thickened bowel loop with stricture along the splenic flexure and large descending bowel displacement medially with adhesion. Because of the acute obstruction with poor clinical condition the patient underwent left hemicolectomy, proximal colostomy and distal mucous fistula formation. The surgically resected splenic flexure was all pathologically and immunohistochemically diagnosed as diffuse large B-cell lymphomas (DLBCL). The patientis was on advance life support and ventilatory support and died 15 days after the surgery by multiple organ dysfunction syndromes. Conclusions: Primary colonic lymphomas represent a rare minority among the colonic neoplasm’s and if not correctly diagnosed can have poor outcome. This case highlights the difficulty in diagnosing of primary colonic lymphoma at splenic flexure. Keywords: Mucous fistula, primary colonic lymphoma, Adenocarcinoma.
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